Hospital Ends Nightmare Of Troubled Sleep

May 20, 1985|By Jean Marbella, Medical Writer

To sleep, perchance to dream -- easy for Shakespeare to say.

For some people, a good night`s sleep is just a dream. But now those people -- the snorers, the insomniacs, the narcoleptics and the just plain drowsy -- may find some rest in an obscure room on the fourth floor of Broward General Medical Center.

There, the hospital`s little-known sleep lab operates in the dead of the night, monitoring the troubled sleep of patients suffering from various sleep disorders -- a range of conditions that can be anything from merely annoying to life-threatening.

The lab -- basically a private room where the patient is hooked up to equipment and monitored through the night by a technician in an adjoining room -- is the county`s only hospital specializing in sleep disorders.

Operating less than two years, the lab already has treated some rather interesting cases -- such as Milton Lewis, the man whose wall-rattling snoring produced one of Broward`s more amusing condominium disputes.

``My wife says I don`t sound so loud now,`` said Milton Lewis, whose nocturnal noisemaking so disturbed a neighbor that she began pounding on the walls to wake him up, thus waking up other neighbors. As a result, Lewis almost didn`t get his rental lease renewed.

``But no more problems now,`` said Lewis, who went to the sleep lab last month and was prescribed medication and weight loss to modify the condition that caused his snoring.

Lewis, like most of the lab`s patients, suffers from sleep apnea, an occasional breathing stoppage that, should it last too long, could be fatal. His airway would become obstructed during sleep, which is why he would wake up almost every two hours and why he snored so loudly.

``I would get up in the morning and I was awfully tired, like I hadn`t even slept,`` he recalled.

``They have extra fat in their throat and, when their muscle tone drops at night (as they fall asleep), that tissue actually obstructs the airway,`` Singer said.

``When the oxygen gets low enough, the brain sends a signal, `I`m suffocating,` and the patient is roused up. The obstruction is also why they have this rip-roaring snoring.``

Like other people referred to the lab by their doctors, Lewis was put through a basic, one-night stand. Patients check in at 9 p.m., go through some prepatelevision in an adjoining room for those who can`t sleep, but most patients are able to hit the sack on time. They`re usually roused at 6 a.m. the next day.

But in between, the monitors check every little thing -- brain waves, muscular activity, cardiac rhythm, oxygen saturation, chest and lung movement and the air flow in the nose and mouth.

The results come in on a multichannel board that is watched all through the night by senior technician James Lapiana. On reams of paper -- at least 1,000 pages for a night`s worth of data -- the jagged lines tell a fascinating chronology of how the patient slept.

The pages -- each representing 30 seconds -- are ``graded`` the next morning by chief technician Terry Trobaugh, who then turns the results over to Singer.

Singer can scan the pages and tell when the patient began to lapse into sleep by the line that shows the muscles relaxing. He can tell when the patient was snoring by a line from the chin movement monitor. He can tell when the patient started to lose some oxygen and, in reaction, when his body`s electrical activity increased to save himself from suffocating.

``There`s literally been an explosion in sleep research in the last 10 or 20 years,`` said Singer, a pulmonary specialist. ``A lot of the people who used to die in their sleep might actually have had sleep apnea.``

Sleep apnea is easily undetected and could contribute to other medical problems such as high blood pressure and irregular heart functioning, Singer said.

``When the body senses low oxygen levels, it reacts by trying to produce more red blood cells,`` he said. ``That can predispose you to stroke and heart attack.``

In his search for a cure to his snoring, Lewis went through a battalion of doctors.

``First I went to my family doctor. There was nothing he could do, so he sent me to a ear, nose and throat specialist. There was nothing he could do, So he sent me to a pulmonary specialist,`` Lewis said. That was Singer at the sleep lab.

Sleep apnea can be treated with medication that varies the stages of sleep, keeping the persons out of the stage in which muscles are most lax and thus obstruct airway passages, Singer said. Other drugs can be used that heighten respiratory functions. Severe cases may require surgery, he said, to open up the airway.